Provider Demographics
NPI:1275704371
Name:CHEN, HUI JIE JENNY (MD)
Entity Type:Individual
Prefix:
First Name:HUI
Middle Name:JIE JENNY
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 CRANE ST
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4260
Mailing Address - Country:US
Mailing Address - Phone:650-498-6530
Mailing Address - Fax:650-329-0586
Practice Address - Street 1:1300 CRANE ST
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4260
Practice Address - Country:US
Practice Address - Phone:650-498-6530
Practice Address - Fax:650-329-0586
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA981172085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGJ089FMedicare PIN
CAGJ089MMedicare PIN
CAGJ089NMedicare PIN
CAGJ089VMedicare PIN
CAGJ089WMedicare PIN
CAGJ089EMedicare PIN
CAGJ089TMedicare PIN
CAGJ089JMedicare PIN
CAGJ089XMedicare PIN
CAGJ089KMedicare PIN
CAGJ089PMedicare PIN
CAGJ089DMedicare PIN
CAGJ089CMedicare PIN
CAGJ089GMedicare PIN
CAGJ089ZMedicare PIN
CAGJ089IMedicare PIN
CAGJ089OMedicare PIN
CAGJ089QMedicare PIN
CAGJ089RMedicare PIN
CAGJ089SMedicare PIN
CAGJ089HMedicare PIN
CAGJ089LMedicare PIN
CAGJ089UMedicare PIN